Dent a Equipm

7/30/2019 Dent a Equipm

1/70

DENTAL ANESTHESIA &SURGICAL EQUIPMENT


2/70

What is anesthesia?

Traditionally, it means

the condition of having

sensation blocked.

This allows patients toundergo surgery and

other procedures

without the distress and

pain they wouldotherwise experience.


3/70

History of Anesthesia

Horace Wells, a dentist in

Connecticut, U.S.A. founded

anesthesia

Wells was astounded to see aman inhale Nitrous Oxide and

despite the mans injuries, the

latter apparently felt no pain. He

pursued his studies on nitrousoxide from whence general

anesthesia was born.


4/70

GENERAL ANESTHESIA

1. Inhalation Anesthesia- nitrous oxide, ether,

chloroform, ethylene,

cyclopropane, ethyl

chloride- inhalation anesthesia

not widely used:

trichlorethylene &

divinyl ether

2. Intratracheal Anesthesia

3. Intravenous Anesthesia

4. Rectal Anesthesia


5/70

Regional Anesthesia

injection near a cluster of nerves to numb thearea of your body that requires surgery

may remain awake, or you may be given a

sedative Spinal analgesia, (or commonly called spinal

anesthesia or sub-arachnoid block (S.A.B.))

is a form of regional anaesthesia involvinginjection of a local anaesthetic into thecerebrospinal fluid (CSF), generally through along, fine needle, usually 3.5 inches long.


6/70

Local Anesthesia

drugs that have little or no irritating effects

when injected into the tissues, and that will

temporarily interrupt conduction when

absorbed into the nerve

produce a loss of function in pain,

temperature, touch, proprioception, and

skeletal muscle tone. anesthesia of a small part of the body

Infiltration and block anesthesia


7/70

Infiltration Anesthesia

most commonly used local anesthetic

technique

infiltrated directly into the surgical site

by means of either intradermal

injection or subcutaneous injection


8/70

Block Anesthesia

anesthetic agent is circumferentially

injected around the surgical site

without injecting the area to be

excised

prevents the nerve impulses fromentering the area


9/70

Popularity of Local Anesthesia

1. Simplicity of use- economical and

nonexplosive; postoperative observation is

lessened

2. Undesireable side effects of general

anesthesia are avoided

3. Ideal method for ambulatory patients, for

short and superficial operations


10/70

Why is local anesthesia not widely

used?

1. Lack of patient acceptance and the desire

to be unconscious during operation

2. Impracticality of anesthetizing some bodily

areas

3. Insufficient duration of local anesthesia

4. Rapid absorption of local anesthetics into

the blood stream


11/70

Regional Anesthesia

injection near a cluster of nerves to numb the

area of the body that requires surgery

may remain awake or may be given a

sedative

Spinal anesthesia- form of regional

anesthesia involving injection of a local

anesthetic into the cerebrospinal fluid (CSF),generally through a long, fine needle, usually

3.5 inches long.


12/70

IDEALISTIC ANESTHETIC

1. Its action must be reversible.

2. It must be non- irritating to the tissues &produce no secondary local reaction.

3. It should have a low degree of systemictoxicity.

4. It should have a rapid onset & be of

sufficient duration to be advantageous.5. It should be relatively free form allergic

reactions.


13/70

IDEALISTIC ANESTHESIA

6. It should have a potency sufficient to givecomplete anesthesia w/o using harmful

concentrated solutions.

7. It should have sufficient penetratingproperties to be effective as a topical

anesthetic.

8. It should be stable in solution & readily

metabolized by the body.

9. It should be either sterile or capable of being

sterilized by heat w/o deterioration.


14/70

ADVERSE EFFECTS

Localized prolonged anesthesia or

parasthesia

Systemic reactions

Lack of anesthetic effects


15/70

INJECTABLE ANESTHETICS

1. Procaine Hydrochloride2. Lidocaine Hydrochloride

3. Mepivacaine Hydrochloride

4. Pyrrocaine Hydrochloride5. Tetracaine Hydrochloride

6. Propoxycaine Hydrochloride

7. Butethamine8. Metabu tethacaine Hydrochloride

9. Meprylcaine Hydrochloride


16/70

Topical Anesthetics

form of anesthesia obtained by the

direct application of the drug to the

mucous membrane surface

Iodocaine, tetracaine, cocaine,

benzocaine, and dycloninehydrochloride


17/70

VASOCONSTRICTORS

factors that cause the narrowing of the blood

vessels resulting from contracting of the

muscular wall of the vessels

added to injectable local anesthetics to

prolong and increase anesthesia, reduce

toxic effect, and reduce bleeding


18/70

Antihistaminics

Tripelennamine (Pyribenzamine)

Diphenhydramine (Benadryl)


19/70

Action of Local Anaesthesia

Blocks Sensation

Produces Numbness

Does not cause unconsciousness Reversible

Has a certain onset and duration


20/70

Nerve Supply of the Dentures


21/70

Dental Anaesthesia

Synthetic

Procaine

Chloroprocaine

Topical Anaesthesia

Pipeprocaine

Hexylcaine

Tetracaine

Non-ester compounds

Dibucaine

Lidocaine

Mepivacaine


22/70

Cocaine

The first effective local anesthetic

An alkaloid originally extracted from the

leaves and bark of South American coco

Plants

Onset 1min

Duration 30mins

It is being prevented to use in clinical

operations


23/70

COCAINE


24/70

Procaine

First Synthetic Local

Anaesthesia

Mostly used in Dentistry

Ester base

Used for infiltration

anaesthesia

Rapid Onset

Short duration

Low potency

Lacks topical anesthetic

activity


25/70

PROCAINE


26/70

Chloroprocaine

Ester base

Similar in structure of procaine

Onset is 5 to 15mins Duration 30 to 45mins

Low potency

Very low toxicity


27/70

CHLOROPROCAINE


28/70

Pipeprocaine

Ester base

A derivation of bezoic acid

Topical anesthesia

Slow onset compared to

procaine


29/70

Hexylcaine

Topical and infiltration anesthesia

Short duration (10mins)

Overdose can lead to headache, tinnitus,convulsions and respiratory arrest


30/70

Tetracaine

Available in preparations for topical use

Ester Type

Potent but safe Onset 3-10mins

Long Duration

More toxic compared to other anesthetics Non-irritating when injected to the tissues


31/70

TETRACAINE


32/70

Dibucaine

Cinchocaine

Amide base

Rapid onset

Extremely potent

High toxicity


33/70

LIDOCAINE

Most widely used

Amide base

Injected for local infiltration Onset 15mins

Duration 30-120mins

inherent Potency Moderate Toxicity


34/70

LIDOCAINE


35/70

MEPIVACAINE

Amide base

Used in Nerve block

and local infiltration

Indicated also inregional anaesthesia

Onset 15mins

Duration 60-140mins

Moderate Potency

Moderate Toxicity


36/70

MEPIVACAINE


37/70

Properties of Local

Anaesthesia

Properties Ester base Amide base

Metabolism rapid by plasmacholinesterase

slow, hepatic

Systemic toxicity less likely more likely

Allergic reaction possible - PABAderivatives form

very rare

Stability in

solution

breaks down in

ampules (heat,sun)

very stable

chemically

Onset of action slow as a generalrule

moderate to fast

pKa's higher than PH = 7.4(8.5-8.9)

close to PH = 7.4

(7.6-8.1)


38/70

Abscess or pus A dental abscess is an

infection of the mouth, face,

jaw, or throat that begins as

a tooth infection or cavity.

caused by bacteria that

invade the soft tissue

surrounding your tooth or

at the root of your tooth.


39/70

Abscess or pus

There are several symptoms of an abscessed tooth:

A sharp or shooting pain in the tooth

Chewing causes pain

Loose tooth

Tooth is sensitive to hot or cold fluids or food

Fever

Bad breath

Red and swollen gums

Swollen glands in the neck


40/70

Equipment for drainage

Gauze and gauzedressing

Rubber drainage


41/70

Waste containers

scissors

Cotton pliers

hemostats


42/70

Hemorrhage

Excessive discharge of blood from the

blood vessels; profuse bleeding.


43/70

Methods to stop the Hemorrhage:

1. Bite the gauze for a few minutes

2. Application of astringent substances on top

of the wound

3. The use of materials which provide a frame

or matrix for the blood clot

4. Clotting ingredients

5. Blood transfusion


44/70

Surgery Armamentarium1. Anesthesia

2. Dental syringes for

block or infiltrationanesthesia

3. Syringes for possible

emergency

4. scalpel
http://upload.wikimedia.org/wikipedia/commons/7/71/DentalSurgicalExtraction.jpg


45/70

Surgical Paraphernalia

Mouth mirror scalpel


46/70

Cotton pliers


47/70

Sterile cotton


48/70

Spatulas


49/70

Flashlights


50/70

Aspirator


51/70

Bone files


52/70

Saws


53/70

Chisels

S i f i i i d


54/70

Scissors for incising gums and

soft tissues.


55/70

Cheek retractors, tissue retractors


56/70

TISSUE FORCEP


57/70

CURETTE


58/70

HEMOSTATS


59/70

ELEVATORS


60/70

SURGICAL NEEDLE


61/70

NEEDLE HOLDERS


62/70

BONE RONGUER


63/70

ASPIRATOR


64/70

FORCEPS


65/70

MAXILLARY FORCEP


66/70

MANDIBULAR FORCEP


67/70

FORCEP FOR THE ANTERIORS


68/70

BONE CHISEL


69/70

MALLET


70/70

Documents

Dent a Equipm